Individual
DR. STEVEN RICHARD SQUILLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
48 SOUTH RD UNIT 8, SOMERS, CT 06071-2160
(860) 763-4733
Mailing address
P.O. BOX 801, SOMERS, CT 06071-1206
(860) 763-4733
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2122
CT
152WC0802X
Corneal and Contact Management Optometrist
3270
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0353418
—
MA
05
—
4243648
—
CT
Enumeration date
09/19/2005
Last updated
04/22/2020
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